So many folks express views that are obviously self-serving, but they try to masquerade them as altruistic positions that benefit some other constituency. These attempts usually fool no one, but yet these performances are common and ongoing. They are potent fertilizer for cynicism.
Teachers’ unions have been performing for us for decades. Their positions on charter schools, school vouchers, merit pay and the tenure system are clear examples of professional advocacy to protect teachers’ jobs and benefits; yet the stated reasons are to protect our kids. Yeah, right. While our kids are not receiving a top flight education, the public has gotten smart in a hurry on what’s really needed to reform our public educational system. This is why these unions are now retreating and regrouping, grudgingly ‘welcoming’ some reform proposals that have been on the table for decades. This was no epiphany on their part. They were exposed and vulnerable. They wisely sensed that the public lost faith in their arguments and was turning against them. Once the public walked away, or became adversaries, established and entrenched teachers’ union views and policies would be aggressively targeted. Those of us in the medical profession have learned the risk of alienating the public. Teachers have been smarter than we were.
The medical profession is full of ‘performances’ where the stated view is mere camouflage. For example, Read more »
Periodically, the FDA publishes drug warnings that should be shared with the public, especially if it affects pregnant women. Each year, over 4 million babies are born in the US and 43% will continue to be breast fed at 6 months. All of these moms will invariably use meds at some point after birth, so which meds are helpful and which are potentially harmful? These questions may now be answered by the Infant Risk Center, at the Texas Tech University Health Center, in Amarillo, Texas. This center provides up-to-date information regarding the safety of medications that are taken both during pregnancy and after birth.
Most drugs enter breast milk immediately after birth and during the first 4 to 10 days of life at a fairly fast rate based on the physiology of breast cells. New moms must therefore be careful of pain medications that are prescribed during the post partum period. Hydrocodone aka Vicodin is a potentially addictive opiate that is given for pain management. When it is processed by the body, it breaks down into a component called hydromorphone that is even more potent. The University of California at San Diego Medical Center performed a small study to determine how much of the drug is secreted into breast milk and what percentage is absorbed by newborns. 3 to 4% of hydromorphone was found in breast milk which is considered safe. As a rule of thumb, nonopioid medication should be prescribed first during the post partum period for pain relief. If the pain persists, no more than 6 Vicodin (hydrocodone) tablets or 30 mg should be prescribed in one day. Dosages greater than 40 mg should be avoided and the newborn should be monitored carefully for depressed behavior or inadequate breastfeeding.
Recently the FDA sent a drug warning to healthcare providers regarding the risks associated with the entire class of antipsychotic medications such as Haldol, Risperdal®, Risperdal® Consta®, Invega® and Invega®Sustenna, Clozaril, Zyprexa, Seroquel, Abilify, and Geodon. These medications are used to treat schizophrenia and bipolar disorders but are associated with abnormal muscle movements and withdrawal symptoms of newborns whose mothers took these medications during the third trimester. However it is recommended that patients should not abruptly stop taking these medications without speaking with their healthcare professional first. For further information, readers may go to the FDA website http://www.fda.gov/Drugs/Drug Safety/ucm243903.htm.
Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
The University of California-San Francisco (UCSF) has made a significant announcement that could be a watershed moment for how medications are given to hospital patients in the United States.
In a typical hospital setting, patients are receiving many different types of prescription medications — ranging from mundane vitamins to more intense drugs such as chemotherapy. In the thousands of times medications are given to patients, and with the high number of humans handling the process of organizing and giving the medications, human error is bound to occur. And medication errors can be life threatening — especially if related to a chemotherapy agent.
UCSF wants to make the rate of error for medication administration to be zero. In order to do this, they are using robot technology to prepare and track medications, with the main goal, obviously, being to improve patient safety. In the phase-in of the project, not a single error occurred in the 350,000 doses of medication prepared — remarkable.
Once computers at the new pharmacy electronically receive medication orders from UCSF physicians and pharmacists, the robotics pick, package, and dispense individual doses of pills. Machines assemble doses onto a thin plastic ring that contains all the medications for a patient for a 12-hour period, which is bar-coded.
There are some key advantages this system brings to the workflow of a hospital setting:
— The robots can do chemotherapy dosing, one of the toughest and most sensitive things to do. They can also do complex IV medication dosing.
— There is no touching of the medications by hand. The medications come from the manufacturer, are processed by the robots, and then sent to the nurses and the patient’s bedside in sterile packaging.
— The robots allow for pharmacists and nurses to be more efficient by taking away repetitive tasks. While they do not replace either, they enable a healthcare system already stretched for resources to increase productivity.
— The system costs $15 million, but with the payoff in regards to improved patient outcomes, as well as time saved, the investment should make this endeavor by UCSF more than worthwhile.
Bacterial contamination of physicians’ newly laundered uniforms occurs within three hours of putting them on, making them no more or less dirty than the traditional white coats, researchers reported.
Researchers sought to compare bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians’ white coats to freshly laundered short-sleeved uniforms, and to determine the rate at which bacterial contamination happens. They reported results in the Journal of Hospital Medicine.
ACP Internist‘s blog recently took up the debate as well. The issue has cropped up over the years, assessing not only the cleanliness but the professionalism inherent in the white lab coat.
Researchers conducted a prospective, randomized, controlled trial among 100 residents and hospitalists on an internal medicine service at Denver Health, a university-affiliated public safety-net hospital. Subjects wore a white coat or a laundered, short-sleeved uniform.
At the end of an eight-hour workday, no significant differences were found between the extent of bacterial or MRSA contamination of infrequently-washed white coats compared to the laundered uniforms. Sleeve cuffs of white coats were slightly but significantly more contaminated than the pockets or the midsleeves, “but interestingly, we found no difference in colony count from cultures taken from the skin at the wrists of the subjects wearing either garment,” researchers wrote.
And, there was no association found between the extent of bacterial or MRSA contamination and the frequency with which white coats were washed or changed. Colony counts of newly laundered uniforms were essentially zero, but after three hours they were nearly 50 percent of those counted at eight hours.
*This blog post was originally published at ACP Internist*
In less than six months after I wrote “Seven Reasons Why Pregnancy Becomes a Deadly Affair,” the public outrage is faint and inaudible regarding domestic violence committed against pregnant women. The subject therefore needs to be revisited again.
On a college campus less than 90 minutes away from my home, a 17-year-old woman was kicked and punched in her abdomen for no apparent reason other than that she carried life within her womb. The alleged father of her baby, Devin Nickels, a college student at Florida State University (FSU), was apparently not happy about his new prospective role. He purportedly contacted a high school buddy, Andres Luis Marrero, who now attended the University of Tampa, and asked him to beat his girlfriend until she had a miscarriage for $200.00. Marrero, instead, offered to assault the girl for free.
According to the University of Tampa’s newspaper, The Minaret, Nickels drove his girlfriend to a secluded wooded area near an apartment complex and Marrero allegedly assaulted her despite her pleas that she was pregnant. The woman was treated at a local hospital and her pregnancy was still viable. Hours later, Marrero allegedly wrote about the attack on his Facebook wall describing it as “fun.” He was subsequently arrested for armed kidnapping and aggravated assault on a pregnant woman. His father made a statement that his son was an “outstanding kid all his life” and he had no idea “where this was coming from.” Nickels was also arrested on the FSU campus.
Unfortunately these travesties continue. The Oakland Pressreported the story of a 17-year-old Ypsilanti, Michigan high schooler who allegedly stabbed a classmate (with whom he’d had sex) in the back of the head 12 times because she told him she “might be pregnant.” She ultimately had surgery that resulted in an intensive care unit admission. The classmate lived because she “played dead.” Read more »
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The University of California-San Francisco (UCSF) has made a significant announcement that could be a watershed moment for how medications are given to hospital patients in the United States.
